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Question please ? With Daisy now taking three drugs till we go back for a review on the 7 Nov do I allow a time gap between them ,I allow an hour between the
Cimetidene and Gabapentin but when should I give her the Loxicom.?

Daisy and I go back to see her Neuro at 5.30 pm today ,she is currently on Cimetidene 50mg x 3 ,Gabapentin 100 mg x 3 and Loxicom 8 ml once a day .
How long should she be on Loxicom and as she is still scratching a bit any thoughts pls on how you think her Neuro might approach the problem now,I have
looked at CR alogarithm but cannot work out what direction Daisy should go .I like to have some knowledge and ideas to discuss with her Neuro rather
than sit there like and idiot saying nothing so help and thoughts please.

I like to have some knowledge and ideas to discuss with her Neuro rather
than sit there like and idiot saying nothing so help and thoughts please.

Brian,

I doubt you would ever look like an idiot because you do so much for your girls and continue to look for help etc.

I wish I could offer more help but since Ella is no longer with me and also from what I have read about Daisy's symptoms, they seem very different from Ella. It is so hard because each dog is different and it can be hard to find the right medication combination. I will say that once you do, it can make a big difference but of course sometimes that needs to change.

I know you said you have studied Dr. Rusbridge's treatment algorithm but have you thought about trying pregabalin (lyrica)? All I know is it really helped Ella but like I said, her symptoms seem different. The main difference I saw was she seemed like a different dog because light came back into her eyes. I am not sure if it was because gabapentin made her more tired or something else. I think you mentioned that she still is pretty active (I think) Ella also had issues with mobility (climbing stairs etc.) which I saw an improvement (and I don't think that is a problem with Daisy).

What I had wished I had done and that others have suggested, was to add or change one medication at a time so you can see what one was helping (or not) certain symptoms. I think I also started adding prednisone at the same time I switched to Lyrica (but she also took it sometimes befor) which may have contributied to the improvement with her mobility and not lyrica.

Ella was managed for sometime but eventually we added amantadine and she had tramadol. According to CR alogarithm, it says that if gabapentin is not showing improvements to try lyrica or/and amantadine and mentioned tramadol. Honestly, I am not sure if the amantadine helped her in the end but the tramadol did when she was in a lot of pain.

I really don't know what to ask and I am sorry. I just can share my experience and Ella did not have the head tilt that you mentioned.

I know you care and I am deeply grateful .I am just nervous about going down this road too quickly and then getting
to the end and having nothing left to turn to ,time seems to go much to fast but i of course will sit and listen and then
we will decide as of course I do trust her Neuro .

I will pick Daisy up from home at 5.00 put her in her harness on the front seat by me and then when I am driving down the
motorway M53 at 70 mph Daisy starts talking to me as she wants to sit on my knee but I dont think our police will enjoy
Daisy driving but she is a capable little girl .

Brian most of us with SM dogs would not be able to get rid of scratching entirely. All my SM dogs scratch to some degree. Adding in anything further or changing treatment depends on how much, how vigorous, is it distressing for the dog, whether that indicates an increase in other deficits that an owner or vet cannot see but a neurologist likely can. It is always useful to go in with a video or two. Sadly this disease almost always progresses and most of us will see the return of symptoms and must debate what that means and whether to change treatment. It is very wise to do this with a neurologist who can often see what we owners cannot.

Of course if you are putting a dog in the front seat( not the safest place to be regardless, especially if only in a harness restraint) be sure to turn off the airbag -- an airbag would crush a small dog (which is why there are laws about putting babies and small children in front seats -- I think it is worth considering if a dog's life has the same value as a child's would, for any owner putting dogs up front. Most of us would say dogs are indeed deeply cherished by us -- and given they are the size of a baby and therefore at all the same fatality and serious injury risks, surely would always be safer in proper restraint in the back. ).

Let us know what your neuro says.

With mild scratching I sure would not be adding more to Daisy's treatment unless they see discomfort and other progression changes.

I felt similar about switching from Gabapentin to Lyrica. I always thought of Lyrica as the last resort and I did not want to get there too soon. Coco recently had a serious crisis, her anal gland infection pushed her into heart failure and triggered acute sm pain. Until this time Coco never really displayed severe sm pain episodes, rarely scratched but would sometimes yelp. We switched her from Gabapentin to Lyrica , Coco is a completely different dogs, she is very playful and mischevious. I feel very guilty I did not do this sooner!
The problem is we do not know how much pain they are really suffering, I would imagine they learn to live with a lot, combined with wanting to please us and their high levels of serotonin we should try everything we can to make sure they are not suffering.

I know I am totally wrong in letting Daisy sit in the front but she and I know she is the boss and winds me around her little paw ,but that's our Cavaliers
but I promise no more driving for her .This is the harness we use for Rosie and Lily who are the two normally on the back seat while Poppy and Daisy go
in the crate in the back.http://www.fleecedogharnesses.co.uk/...FSbMtAodpCcA5g.

We spoke about all the alternatives for Daisy who was scratching quite a lot in front of Ulreke and it was decided for the next two weeks, till we go back
on the 23 rd Nov, to reintroduce Omeprazole 10 mg x 1 and to keep her on the Cimetidene 50 mg x 3 and up her Gabapentin from 100 mg x 3 to 200 mg x 3
and take her off entirely the anti inflamatory Loxicom which seemed for Daisy to not help at all .If after two weeks there is no change it is likely then that
we will try Lyrica . I watch Daisy a lot and am still puzzled as I can see no physical sign of pain and she still outwardly displays exactly the same fun loving
look at me the centre of attention character she was and still is as when she was one or two ,she argues with Poppy for the title of boss Cavalier and wants
the toy that Rosie or Lily may have ,she has never ever screamed or acted or displayed any sign of pain and I wonder why ? I want to enjoy Daisy and
for her to enjoy herself so we will continue to go back to her Neuro as and when needed until this thing is under some form of control.
Thanks for your comments it does so help to share .The coffee machine has gone but then it hasn't worked for a bit .

We saw her neuro last night for a progress check ,I advised she is still scratches occasionally, but not a lot, and that her
medication of 2x100 mg Gabapentin from what I can see has not really made any great change to her scratching .I requested
a possible increase of the Gabapentin from 2 daily to 3 but her neuro wanted to include Omeprazole into her meds and of course
did not want to vary two meds at the same time so it was decided to proceed with the inclusion of the 10 mg of Omeprazole for
a three week trial then possibly increase the Gabapentin to 3x daily if needed .Her daily meds are now 3x50 mg Zitac ,2x100 mg
Gabapentin and 1x daily of 10 mg Omeprazole .I asked why would she take both the Zitac and Omep if they are both CSF reducers
and was advised that the Zitac acts as a fluid reducer and the Omep acts to try and reduce the production of spinal fluid ,am I right here or am I suffering from information overload . Any comments ,thoughts,advice or guidance most welcome please .

Daisy unfortunately has what was a small pimple on her left side which has now developed into a larger fibrous cyst/wart which I know has to be removed so I have arranged an appointment with a surgeon at C/Gates right after we see her neuro in three weeks time ,so tonight its off to my local Vets with Daisy to ask for a referral letter to them on the grounds that as she has a Grade 4 murmur I would like C/Gates to operate as they have a full time anaesthetist and a complete range of emergency equipment . My poor Daisy .

My Dawn's hospital appointment last Friday resulted in the endoscophy finding more ulcers some of which are still bleeding and with her
colonoscophy she found it to be too painful halfway through the procedure and told them to stop. So she has been summoned back to
see her consultant who wants her to have the colonoscophy again ,we go on .

What about a virtual colonscopy for Dawn?
I hope the new med regime will help Daisy.